Treatment of vaginal vault prolapse with abdominal sacral colpopexy using prolene mesh

We report our experience on abdominal sacral colpopexy (CSP) with a prolene mesh in women with vaginal vault prolapse.

From 1994 to 1997 15 patients (average 57 years), underwent CSP. All patients suffered from a serious vaginal vault prolapse. Eight of them also had a uterine prolapse. Seven patients had already been operated for hysterectomy (5 vaginal, 2 abdominal). Four of them had already been operated for urinary incontinence: (3 Raz, 1 Burch). In 6 cases we have a colposuspension according to Burch associated with CSP. Average follow-up was 15 months.

All the patients have carried a bladder catheter for 4-12 days (average 5 days). The patients who were sexually active have begun having normal sexual intercourse again. Neither relapses of the treated prolapses, no infections or rejections of the prosthesis have been verified. In 1 patient pollakiuria insensitive to anticholinergics has persisted. Four patients have complained of hypogastric "sense of weight", without any clinical evidence of pathology.

Our survey confirms the information and the good result of this technique in the treatment of the total vaginal dome prolapse, also in comparison with our operations for sacrospinosous ligament fixation. This kind of treatment through the vagina, is not always possible, above all after hysterectomy with a very short vagina.